Anti-retroviral pills save lives

Oct 26, 2003

THE use of highly active anti-retroviral therapy (HAART) has enabled thousands of Ugandans living with HIV/AIDS to live longer, doctors have said.

By John Odyek and Anne Mugisa

THE use of highly active anti-retroviral therapy (HAART) has enabled thousands of Ugandans living with HIV/AIDS to live longer, doctors have said.

British scientists last week reported that nine out of 10 patients using HAART can expect to live for more than 10 years. Without HAART, only half would live that long. The treatment involves a combination of medicines referred to as anti-retroviral drugs (ARVs).

The director, Joint Clinical Research Centre (JCRC) Dr Peter Mugyenyi, said Uganda loses 300 AIDS patients a day, compared to South Africa where about 1,000 die per day. He said the relatively low death rates in Uganda were attributed to HAART.

Less than 15,000 Ugandans are currently on HAART, but the total number of patients who need it immediately, is estimated at 150,000. Nevertheless, Uganda is one of the countries with the highest numbers of patients on HAART. All together, the number of Africans on HAART is estimated between 50,000 and 80,000. This is only a tiny fraction of those who need it.

Mugyenyi said HAART has been used in Uganda since the mid 1990s. However, it was not until the late 1990s, when the prices began falling, that the number of Ugandan patients on HAART rose to hundreds and eventually thousands.

“HAART has been made more user-friendly and research is continuing to simplify it further. Patients were swallowing up to 18 pills per day but now they are taking between two to 12 pills per day. Some drugs are being combined into one tablet,” Dr Mugyenyi told The New Vision.

At the moment, over 8,000 patients are receiving ARVs from JCRC, where the lowest cost combination costs sh55,000. Several thousand others are receiving the drugs from other centres. The drugs suppress HIV to the extent that the virus cannot be detected in blood.

However, the traces of the virus remain hiding in lymph nodes, and a person who is on HAART may still infect others.

Mugyenyi said HAART was very useful in reducing the incidence of opportunistic infections affecting AIDS patients.

“The hospitals are full of patients dying of opportunistic infections. The infections go down immediately HAART is used,” Mugyenyi said.

Since the beginning of the epidemic in the early 1980s, about one million Ugandans have died of HIV/AIDS. Mugyenyi said the number would have been much lower if HAART had been widely available.

Last Thursday, Government announced its first plan to import ARVs. Tenders for the suppliers were opened last Monday and are currently being evaluated.

Government will initially import ARVs worth US$3m (sh6m), according to Dr. Kihumuro Apuuli, the Director General, Uganda AIDS Commission.

The first beneficiaries of this drug are 200 orphans who will get it from the Mildmay Centre for Palliative Care, the Academic Alliance for AIDS Care and Prevention in Africa (based in Mulago Hospital) and the Joint Clinical Research Centre (JCRC).

Drugs at the Mildmay Centre and at the Academic Alliance will be free, but those at the JCRC will be bought at a subsidised cost.

Eventually, Government plans to provide free ARVs to all Ugandans who need them. A policy has been drafted by the Ministry of Health on ARVs.

The announcement comes ahead of the International Conference for People living with HIV/AIDS, to be held in Kampala this week.

Over the weekend, treatment activists mounted pressure on Government to ensure that all people with HIV/AIDS access quality treatment that can prolong their lives. A public discussion was due to be held in Kampala to address the issue of AIDS treatment in the context of human rights.

Additional reporting by Charles Wendo

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